In these studies we are evaluating in a random double-blind trial the effects of prednisolone versus placebo therapy on patients with alcoholic hepatitis. Patients with alcoholic hepatitis are divided into three categories depending on initial clinical state. Assessments are made of effects of therapy on survival, morbidity, incidence of complications (bleeding, hepatic coma, diabetes, infections) and liver function tests. Histologic evaluation before and after therapy is performed to determine the effects of the treatment regimens on individual components of alcoholic liver disease - alcoholic hyaline, polymorphonuclear infiltration, cell injury and necrosis, fat accumulation and fibrosis. Physiologic parameters assessed before and after therapy include: 1) wedged hepatic venous pressure as an index of portal hypertension; 2) BSP storage and maximal excretory rate; 3) plasma volume measured by I125-labelled albumin; 4) hepatic protocollagen proline hydroxylase activity in needle biopsy specimens and urinary hydroxyproline excretion as indices of fibrogenesis. Upon completion of the initial trial, we shall examine the effects of d-penicillamine in patients with alcoholic hepatitis as compared to prednisolone or placebo. These studies are designed to determine the effects of d-penicillamine as an antifibrotic agent in the prevention of progression from alcoholic hepatitis to cirrhosis.